Diseases and Conditions

Below is a list of diseases, conditions, and problems frequently encountered in our clinics:

1. Symptoms: Acute or chronic cough, shortness or breath, wheezing, chest pain, hemoptysis (coughing blood) and fevers are a few of the many symptoms encountered in our clinics. These symptoms may be present alone or in association with an existing condition such as connective tissue disease, occupational or environmental exposures, or a history of cigarrette smoking. Often patients present to our clinic with a diagnosis that does not adequately explain their symptoms. Exhaustive efforts to arrive at an accurate diagnosis and appropriate management plan are the norm at The Emory Clinic.

2. Abnormal chest imaging: We routinely encounter pulmonary infiltrates and infections, pulmonary nodules or masses, other pulmonary parenchymal abnormalities, and pleural fluid collections. Often a multidisciplinary approach is required for diagnosis and treatment, and we foster close relationships with other departments.

3. Abnormal pulmonary function: Evaluation of an abnormal pulmonary function test or low oxygen level noted on routine medical evaluation. The cornerstone of pulmonary diagnostics is the pulmonary function test. Interpretation of these tests is approached carefully, and the test is often repeated if initial results are inconsistent.

4. Abnormal pulmonary pressures: Evaluation of abnormal blood pressure in the pulmonary arteries, routinely identified on echocardiography. This could indicate the presence of a serious pulmonary vascular disease, and may result in referral to our Pulmonary Hypertension Program.

5. Chronic obstructive pulmonary disease (COPD): An obstructive lung disease that typically results from smoking. The disease is not reversible, but often responds well to treatment. Patients present with wheezing, coughing, shortness of breath, respiratory failure and frequent lung infections. The condition is managed based on current guidelines, with the application of newer therapies when appropriate.

6. Asthma: An obstructive lung disease that is seen at any age, often in the absence of smoking, and often associated with allergic conditions. The airway obstruction is mostly reversible, and the condition is highly treatable. Asthma cases that are particulary difficult to manage will be referred to to our Asthma and Allergy Clinic.

7. Lung cancers: Diagnosis and treatment of small cell and non-small cell carcinomas, bronchoalveolar cell carcinoma, and other lung malignancies. A cancer diagnosis is best managed with a multidisciplinary approach, which would mean referral to Winship Cancer Center and/or Surgical referral as well.

8. Interstitial Lung Disease (ILD): A broad and varied group of lung diseases that result in scarring of the lung tissue and associated structures. A confirmed ILD diagnosis would mean referral to our ILD Clinic for possible biopsy and multidisciplinary characterization and management.

9. Acute and chronic respiratory failure: Refers to a loss of pulmonary function resulting in the need for supplemental oxygen and/or other support as indicated. All clinics are equipped to determine appropriate oxygen requirements and the need for additional support such as BIPAP or chronic mechanical ventilation.

10. Acute and chronic lung infections: Refers to common pneumonias, atypical pneumonias, mycobacterial infections, and conditions that predispose patients to recurrent infections, such as cystic fibrosis and bronchiectasis. Recommendations for antimicrobial therapy and pulmonary hygiene therapy are made based on the most up-to-date research being conducted worldwide. Occasionally patients are referred and co-managed by an Infectious Disease specialist, or to the Cystic Fibrosis Program. Immune therapies are recommended when deficiencies are identified.

11. Occupational lung disease: diagnosis, treatment and identification of the offending materials can be challenging, and may require a multidisciplinary approach. Examples include diseases related to asbestos exposure (mesothelioma and malignancies), coal, silica and talc exposure (pneumoconiosis), work related asthma, and hypersensitivity pneumonitis. A careful history is essential to these diagnoses.

12. Venous thromboembolism: Diagnosis and management of DVT and PE, with recommendations for anti-clotting and other therapies based on the most current guidelines. Patients with chronic thromboembolic disease are referred to the Pulmonary Hypertension Program.

13. Alpha 1 Antitrypsin Deficiency: A genetic disease that results in the early development of emphysema, especially when the patient uses smokable tobacco products. Emory U. Hospital at Midtown is an officially designated clinical resource center by the Alpha 1 Foundation. Alpha 1 patients with end-stage emphysema often meet criteria for lung transplantation, referral to the McKelvey Lung Transplant Program may be an option.

14. Sleep disorders: Obstructive sleep apnea and all other sleep-related disorders are seen frequently. Difficult to manage cases are referred to our Sleep Center.

15. Preemptive pulmonary evaluations: Pulmonary evaluation is often required in anticipation of major surgery, prior to initiation of therapies associated with significant pulmonary side effects, or prior to employment in certain occupations. Reports with full recommendations are provided to the referring physician in these cases.

16. Lung Transplantation: Transplantation is an option for patients who have progressive respiratory decline despite optimal therapy for their lung disease. Patients are often referred early in the evolution of thier disease process if they are expected to decline. The best candidates for transplant are those who are relatively healthy otherwise, with decent functional capacity and strong social support. Common indications for lung transplantation include advanced COPD, cystic fibrosis, alpha 1 antitrypsin deficiency, pulmonary fibrosis and pulmonary hypertension (see McKelvey Lung Transplant Program).

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